Job-Related Trauma and Post Traumatic Stress Disorder (PTSD)

banner image of firefighters and law enforcement officers

Photos by Jim Macmillan, Philadelphia Daily News

"The credit belongs to the man who is actually in the arena; whose face is marred by dust and sweat and blood; who strives valiantly; who errs and comes up short again and again; who knows the great enthusiasms; the great devotions, and spends himself in a worth cause; who, at the best, knows in the end the triumph of high achievement; and who, at worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who know neither victory nor defeat." –Teddy Roosevelt, President, 1901-1909

 

Post Traumatic Stress Disorder (PTSD) has become a familiar term used in news reports focusing on the mental health of soldiers returning from combat in Iraq and Afghanistan. The diagnostic manual used by physicians and therapists states that PTSD can develop after "exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways: 1. Directly experiencing the event; 2. Witnessing, in person, the event(s) as it occurred to others; 3. Learning that the traumatic occurred to a close family member or close friend; 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse". (DSM V, 2013). This description does not explain; however, why some people exposed to traumatic incidents develop PTSD and many others exposed to the same incident do not.

The symptoms of Post Traumatic Stress Disorder are connected to responses of a body when survival is threatened.

 

Survival responses of your body almost always take precedence over other bodily functions (as it does in mammals and other species). This is understandable and designed to insure that you live a long life. Threats to your survival by bacteria and other pathogens, by abnormal growths within the body or by attacks by predators, criminals or enemy soldiers each evoke a predictable response designed to counteract these threats and keep you healthy and safe.

 

For example, if you get a large splinter in your arm, your body immediately sends platelets to the break in your skin to prevent excessive bleeding, white cells in your blood surround the splinter, fight any germs that also may have entered your body with the splinter and push the splinter out of your arm. If germs somehow get around this army of white cells and enter your blood, your body often becomes warm with a temperature to help you fight the infection that follows. It is believed your body is trying to kill the offending bacteria by making it so hot it cannot survive.

 

When you skin is torn or cut, in order to protect you from the destructive bacteria that can enter your body through these breaks in your skin and to insure you do not bleed to death, numerous systems in your body will respond quickly to repair the damage. To close the wound in your skin, cells around this cut multiply and grow much faster than normal skin cells. Your body's response to injury is designed to insure that you are healthy and continue to survive.

 

Your body also responds quickly to threats to your survival that take the form of attacks, such as those typical of muggings, rape and engaging the enemy in combat: your heart rate significantly increases, blood in your body moves from your internal organs (like your stomach) to your muscles, increasing their strength; your hunger is turned off, pain sensation decreases, eyesight and hearing change to focus on the threat, as a number of hormones are released which increase attention, speed of response, focus, and other body responses that increase survival.  You may have heard stories of a mother or father who were able to move something very heavy that had fallen on their child…something they could never pick up on a normal day.  Perhaps this has happened to you.